医学
冠状动脉疾病
心绞痛
药物治疗
疾病
血运重建
内科学
心脏病学
冠状动脉搭桥手术
外科
动脉
心肌梗塞
出处
期刊:JAMA
[American Medical Association]
日期:1989-04-14
卷期号:261 (14): 2077-2086
被引量:30
标识
DOI:10.1001/jama.261.14.2077
摘要
To elucidate the factors associated with improved survival following coronary artery bypass surgery, we studied 5809 patients receiving medical or surgical therapy for coronary artery disease. Three factors were associated with a significant surgical survival benefit: more severe coronary disease, a worse prognosis with medical therapy, and a more recent operative date. Patients with more extensive coronary obstruction had the greatest improvement in survival. Patients with a poor prognosis because of factors such as older age, severe angina, or left ventricular dysfunction had a reduction in risk that was proportionate to their overall risk on medical therapy. Survival with surgery progressively improved over the study period and by 1984 surgery was significantly better than medical therapy for most patient subgroups. Thus, contemporary coronary revascularization is associated with improved longevity in many patients with ischemic heart disease, especially in those with adverse prognostic indicators. (JAMA. 1989;261:2077-2086)
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